Urea Supplementation of High Roughage Rations for Wintering Calves

The objective of this research was to study methods of increasing the efficiency of utilization of urea in supplements fed with prairie hay to wintering beef calves. Four wintering experiments were conducted in which weight gains, feed consumption and feed efficiency were used as measures of performance. In addition, a series of in, vitro trials was conducted with ammonia (NH3) and total volatile fatty acid (VFA) production being measured

Adsorption and incorporation of the zinc oxide nanoparticles in seeds of corn: germination performance and antimicrobial protection

The treatments of the seeds are important procedures applied by the agronomical area to improve the culture yield. From these procedures the micronutrients are available for the seeds before and during the germination stages. One high challenge is make efficient these treatment processes and to ensure the adsorption and the incorporation of these micronutrients in the seeds and to improve its performance in the germination phase. In this work studies explored the optimization of the incorporation process and the characteristics of the zinc oxide clusters adsorbed on the surface of the seed. The results were associated with the agronomic responses during the germinations stages of the seeds of corn. The seeds were treated in suspensions containing different concentrations of nanoparticles of zinc oxide and during different treatment times. The adsorptions in the corn surface and the absorption of the nanoparticles for the inner of the seeds were studied together with its antibacterial characteristics and correlated with the germinations indicators. The results showed that is possible to incorporate nanoparticles of zinc oxide in inner of the seeds of corn and improve the germinations indicators. Antibacterial protection was aggregated on the seeds of corn. It´s possible to incorporate 0.280 mg of zinc oxide nanoparticle per seed mass in inner of seeds with the optimal treatment conditions with nanoparticle concentration of 50 mg/L in the suspension and with treatment time of 180 minutes. With the optimal treatment concentration the normal plant percentage increase of 2.70% in relationship to the seeds not treated

User-Centered Design of an Intelligent Pilot Advisory System for Non-Emergency Scenarios: A Case Study

Artificial Intelligence (AI) is being used in an increasing number of fields, so including it aviation as well only comes natural. Therefore, the Intelligent Pilot Advisory System (IPAS) is being developed as a research platform. and is supposed to assist pilots in their decision making. Previously, the research was focused on the IPAS’s application in emergency scenarios. In this thesis, the IPAS is extended for use in non-emergency scenarios to support pilots in normal operation. Hereby, this research explores what functions the system could offer to pilots that are useful to them, pilots’ willingness to use such a system in non-emergency situations, and how to design this system for optimal usability, focusing on explainability and trustworthiness. To design a suitable system, a workshop was held with experts to brainstorm possible functionalities. Hereby, the idea for a Mission Monitoring and Advisory Function (MMAF) was developed. The MMAF encompasses the IPAS to continuously monitor the conditions along the flight route, as well as at the destination airport and to provide updates, strategic insights, and recommendations to the pilots. Additionally, the IPAS is supposed to identify suitable alternate airports in the area. To develop a User-Interface (UI) for such a system, current guideline from research and industry were considered and an iterative user-centered design process was utilized. Lastly, the system was tested in a mixed-methods, between-subjects study with 18 pilots in an Airbus 320 cockpit simulator to evaluate its usability and the impact of explanatory details on user’s trust. The results showed that the pilots were willing to use such a system and that the developed interface has a good usability with a System Usability Scale (SUS) score of 75.49 and a Post-Study System Usability Questionnaire (PSSUQ) score of 2.52. Regarding the perceived trustworthiness of the system, there was no significant difference between both groups, except in the perceived sufficiency of information provided to establish adequate trust. Here, in the second session, the group with more explanatory details rated that they perceived their information to be more sufficient to trust the system adequately. Furthermore, the results highlighted areas for improvement in the interface and showed other possible functionalities to consider in the future

Tratamento com antígeno B, uma lipoproteína secretada pelo Echinococcus granulosus, melhora a artrite experimental aguda

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Matriz de impactos intersetoriais em economia da defesa do Brasil

O presente estudo objetiva a criação de uma ferramenta capaz de mensurar e avaliar os impactos intersetoriais em economia da defesa do Brasil. Estudos sobre economia da defesa ganharam notoriedade no período pós-Guerra Fria, no entanto, ainda não existe tradição em tais pesquisas. Assim, há espaço para novos estudos, uma vez que além de serem poucos os existentes os mesmos não apresentam consenso quanto aos resultados. No Brasil, os investimentos em defesa são baixos, concentrados em pagamento de pessoal e, regionalmente, no Distrito Federal e na região Sudeste. A operacionalização da pesquisa se deu a partir da construção de uma Matriz Insumo Produto (MIP) com a inclusão do setor Defesa Nacional, para tanto, valeu-se da MIP de 2010 com valores atualizados para 2015. Os resultados apontam participação pouco expressiva do setor defesa na economia nacional, contudo, eles são muito próximos a outros setores públicos. Com relação ao multiplicador de emprego do Tipo II, a Defesa ocupa o 1º lugar, possivelmente em decorrência dos altos salários do setor. Quanto as simulações realizadas, para os multiplicadores do Tipo II, um choque de R$10 milhões geraria 191 empregos, R$12 milhões de valor adicionado e R$24,32 milhões de valor bruto de produção.Firstly, the present study aims the creation by a tool capable measuring and evaluating the intersectorial impacts on defense economics in Brazil. Defense studies economics have gained notoriety in the post-Cold Wartime; however, there is still no tradition in such research. Thus, there is an area for new studies, since in addition to being few; there are no consensus on the results. In Brazil, defense investments are low, concentrated in personnel payments and, regionally, in the Federal District and in the Southeast region. Moreover, the operation at research was on the construction of an Input-Output Matrix (IOM) with the inclusion of the National Defense sector, using the IOM in 2010 with updated values for 2015. The results indicate that the sector is not very significant defense in the national economy; nevertheless, they are very close to other public sectors. With regard to the Type II employment multiplier, defense occupies the 1st place, possibly due to the high salaries of the sector. Finally, as for the simulations, for Type II multipliers, a R$ 10 million shock would generate 191 jobs, R$12 million in added value and R$ 24.32 million in gross production

Avaliação dos níveis de miostatina, GDF-11 e irisina no soro e no líquido sinovial de pacientes com artrite reumatoide

Base teórica. A artrite reumatoide (AR) é uma doença autoimune sistêmica, caracterizada por sinovite crônica que leva a destruição da cartilgem e do osso. Os fibroblastos sinoviais (FLS) na AR possuem um papel central na inflamação sinovial e na degradação da articulação. Um mecanismo adicional pelo qual os FLS podem contribuir para a degradação articular na AR é por meio da expressão de miocinas, como a miostatina. Miocinas são citocinas e fatores de crescimento derivadas do músculo esquelético e que têm como funções não apenas a regulação autócrina do metabolismo do tecido muscular, mas também atividades parácrinas. A miostatina é caracterizada por inibir a síntese proteica e aumentar a degradação de proteínas no tecido muscular e por aumentar a osteoclastogênese no tecido ósseo. Outras miocinas que também apresentam atividade nos tecidosmuscular eósseosão o fator de crescimento e diferenciação 11 (GDF11) e a irisina. Em relação ao GDF11, os dados mostram resultados opostos em relação às suas funções nestes tecidos, não havendo um consenso na literatura. A irisina apresenta ações opostas a da miostatina, tanto no tecido muscularquanto no ósseo. Dados sobre níveis séricos e principalmente sinoviais destas miocinas em pacientes com AR ainda são escassos na literatura. Objetivo. Avaliar e comparar os níveis de miostatina, GDF11 e irisina no liquido sinovial e no soro de pacientes com AR usando como controle um grupo de pacientes com osteoartrite (OA). Métodos. Foram realizadas coletas de líquido sinovial e sangue em 11 pacientes com AR e 5 pacientes com OA. A atividade da doença foi avaliada pelo Clinical Disease Activity Index (CDAI). Os medicamentos utlizados pelos pacientes com AR, o tempo de duração da doença e a presença de doença erosiva foram consultados nos prontuários. As análises dos níveis de miostatina, GDF11 e irisina no líquido sinovial e no soro foram realizadas pelo método de ELISA. Resultados. A média de idade dos pacientes com AR foi de 65 anos e a média do tempo de duração da doença foi de 16 anos. A média do CDAI foi de 12,8, sendo que 27,3% dos pacientes foram classificados com atividade baixa da doença e 72,7% com atividade moderada da doença. No momento das coletas 18,2% dos pacientes estavam usando medicamentos modificadores do curso da doença (MMCD) biológicos e 72,7% estavam usando metotrexato. A presença de doença erosiva foi encontrada em 27,3% dos pacientes. A média de idade do grupo OA foi de 66 anos. Os níveis séricos de GDF11 foram mais altos no pacientes com AR do que no grupo OA (347,50 (31,30- 1818,00) versus 31,30 (31,30- 31,30); p=0,052). Os níveis de miostatina e irisina no líquido sinovial e no soro, bem como os níveis de GDF11 no líquido 5 sinovial não foram diferentes significativamente entre os grupos. Nos pacientes com AR os níveis de miostatina e de GDF11 no líquido sinovial foram significativamente mais baixos do que no soro (31,30 (31,30-181,80) versus 817,20 (334,30- 994,70); p= 0,007); (31,30 (31,30-88,13) versus 347,50 (31,30- 1818,00); p=0,018), respectivamente. O tempo de duração da doença nos pacientes com AR foi negativamente associadocom os níveis de miostatina no líquido sinovial (r=-0,684, p=0,02). O CDAI e a presença de doença erosiva não foram associados com os níveis de miostatina, GDF11 e irisina no líquido sinovial e no soro. Conclusão. Nós encontramos níveis séricos de GDF11 mais altos no grupo AR comparado ao grupo OA. Nos pacientes com AR os níveis de miostatina e GDF11 no líquido sinovial foram mais baixos do que no soro.Nossos resultados contribuem para o conhecimento sobre a participação das miocinas na patogênese da AR. Além disso, os níveis séricos mais elevados de GDF11 encontrados no grupo com AR podem estar relacionados a uma tentativa compensatória contra o estado inflamatório da doença.Background. Rheumatoid arthritis (RA) is an autoimmune systemic disease, characterized by chronic synovitis that leads to cartilage and bone destruction. Synovial fibroblasts (FLS) in RA play a central role in synovial inflammation and joint degradation. An additional mechanism by which FLS can contribute to joint degradation in RA is through the expression of myokines, such as myostatin. Myokines are cytokines and growth factors derived from skeletal muscle and whose functions are not only the autocrine regulation of muscle tissue metabolism, but also paracrine activities. Myostatin is characterized by inhibiting protein synthesis and increasing protein degradation in muscle tissue, and by increasing osteoclastogenesis in bone tissue. Other myokines that also have activity in bone and muscle tissues are growth and differentiation factor 11 (GDF11) and irisin. In relation to GDF11, published data have shown contradictory results regarding its functions in these tissues. Irisin has opposite actions to myostatin, both in muscle and bone tissue. Data on serum and mainly synovial levels of these myokines in RA patients are still scarce in the literature. Objective. To assess and compare synovial and serum levels of myostatin, GDF11 and irisin in patients with RA using a group of patients with osteoarthritis (OA) as control. Methods.Synovial fluid and blood were collected from 11 RA patients and 5 OA patients. Disease activity was assessed by Clinical Disease Activity Index (CDAI). Drugs used by RA patients, disease duration and presence of erosive disease were consulted in medical records. Enzyme-linked immunosorbent assay (ELISA) was performed to evaluate myostatin, GDF11 and irisin synovial fluid and serum levels. Results.RA patients presented mean age of 65 years and mean disease duration of 16years. Mean clinical disease activity was 12.8, 27.3% of the patientswere classified in low disease activity and 72.7% in moderate disease activity. Biological disease-modifying antirheumatic drugs(bDMARDs) were being used by18.2% of the patients and 72.7% of the patients were using methotrexate at the time of samples collections.Presence of erosive disease was found in 27.3% of patients.Mean age of patients with OA was 66 years. GDF11 serum levels were higher in RA patients (347.50 (31.30- 1818.00) than in OA group (31.30 (31.30- 31.30); p=0.052). Myostatin and irisin synovial fluid and serumlevels, as well as GDF11 synovial fluid levels, did not differ between RA patients and OA group.In RA patients, myostatin synovial fluid levels (31.30 (31.30-181.80) were lower than in serum (817.20 (334.30- 994.70); p= 0.007) and GDF11 synovial fluid levels (31.30 (31.30- 88.13) were also lower than in serum (347.50 (31.30- 1818.00); p=0.018). Disease duration was negatively correlated with myostatin synovial fluid levels (r=-0.684, p=0.02). CDAI and presence of erosive disease were not associated with 7 myostatin, GDF11 and irisin levels in synovial fluid and in serum Conclusion. We found higher GDF11 serum levels in RA group compared to OA group. In RA patients myostatin and GDF11 synovial fluid levels were lower than in serum. Our results contribute to the knowledge about myokines participation in RA pathogenesis. Additionally, the higher GDF11 serum levels found in RA group could be related to a compensatory attempt against the disease inflammatory state

Avaliação in vitro do potencial terapêutico do extrato de Fasciola hepatica em fibroblastos sinoviais de camundongos com artrite induzida por colágeno

A artrite reumatoide (AR) é uma doença autoimune, crônica e sistêmica, onde a inflamação da membrana sinovial articular leva à degradação da cartilagem e do osso, resultando na destruição articular, dor e incapacidade funcional. De etiologia ainda pouco esclarecida, sua prevalência é de cerca de 0,46% no Brasil e 1% no mundo, com ocorrência maior entre as mulheres. Diversos tipos celulares estão envolvidos na patogênese da AR, porém os fibroblastos sinoviais (FLS) se destacam por apresentarem um fenótipo agressivo que medeia a inflamação e a destruição articular. Apesar dos avanços no tratamento da AR, estes apresentam significativos efeitos adversos, altos custos e limitações, salientando a necessidade da busca por novas estratégias terapêuticas. A Fasciola hepatica (F. hepatica) é um helminto causador da doença fasciolose em ruminantes e humanos. Através de produtos excretores-secretores e antígenos do tegumento, a F. hepatica apresenta propriedades imunomoduladoras, as quais já foram estudadas em diferentes tipos celulares, mas não em FLS. Diante disso, avaliamos nesse trabalho o potencial terapêutico in vitro do extrato de F. hepatica em FLS isolados de camundongos com artrite induzida por colágeno. A viabilidade celular dos FLS foi determinada por ensaio de MTT [3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide], em que os FLS foram expostos ao extrato de F. hepatica nas concentrações de 60μg/ml, 80μg/ml e 100μg/ml, por 24h, 48h e 72h. A capacidade de aderência dos FLS foi avaliada pela exposição das células ao extrato de F. hepatica na concentração de 100μg/ml por 24h. Os efeitos a longo prazo do tratamento com o extrato de F. hepatica na FLS foram avaliados utilizando o ensaio cumulativo de duplicação da população (CDP) após exposição dos FLS a 100μg/ml de extrato de F. hepatica durante 24h. As células foram contadas a cada 2 dias e replaqueadas na mesma concentração inicial por 8 dias. A liberação de interleucina-6 (IL-6) foi avaliada pelo ensaio de ELISA, para este ensaio os FLS também foram expostos ao extrato de F. hepatica na concentração de 100μg/ml por 24h e, após, foram estimulados com o fator de necrose tumoral α (TNF- α). O extrato de F. hepatica foi capaz de diminuir a viabilidade celular em 48h com a concentração de 100μg/ml quando comparado com o grupo DMEM (p<0.05). Em 72h, as doses de 60μg/ml (p <0,001), 80μg/ml (p <0,001) e 100μg/ml (p <0,0001) do extrato de F. hepatica diminuíram a viabilidade celular quando comparadas com o grupo DMEM. O tratamento com 100μg/ml do extrato por 24h apresentou uma tendência no aumento da liberação de IL-6 pelos FLS quando comparados com o grupo DMEM estimulado. No entanto, o extrato não alterou a capacidade de aderência e o crescimento a longo prazo dos FLS. A partir desses resultados, pode-se concluir que o extrato de F. hepatica não apresentou efeito sobre a aderência e o crescimento ao longo do tempo dos FLS, porém apresentou efeito na viabilidade dos FLS e foi capaz de aumentar a liberação de IL-6 pelos FLS. Portanto, embora esses resultados sejam preliminares, eles são importantes para entender a ação do extrato da F. hepatica nos FLS e indicam um efeito imunomodulatório do extrato sobre os FLS.Rheumatoid arthritis (RA) is an autoimmune, chronic and systemic disease, where the inflammation of synovial joints leads to degradation of cartilage and bone, resulting in joint destruction, pain and functional disability. The prevalence of disease is around 0.46% in Brazil and 1% in the world, with a higher occurrence among women. Several cell types are involved in the pathogenesis of RA and fibroblast-like synoviocytes (FLS) have a central role mediating inflammation and joint destruction because of its aggressive phenotype. Despite advances in the treatment of RA, there are still significant adverse effects, high costs and limitations, emphasizing the need to search for new therapeutic options. Fasciola hepatica (F. hepatica) is a helminth that causes fasciolosis in ruminants and humans. Through excretory-secretory products and tegument antigens, F. hepatica presents immunomodulatory properties, which have already been studied in different cell types, but not in FLS. In this work, we evaluated the in vitro therapeutic potential of F. hepatica extract in FLS isolated from mice with collagen-induced arthritis. Cell viability of FLS was determined by MTT [3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide] assay, in which FLS were exposed to extract of F. hepatica at concentrations of 60μg/ml, 80μg/ml and 100μg/ml, for 24h, 48h and 72h. Adherence capacity of FLS was evaluated by exposing the cells to the extract of F. hepatica at a concentration of 100μg/ml for 24h. The long-term effects of treatment with F. hepatica extract on FLS were evaluated using the cumulative population doubling test (CDP) after exposure of FLS to 100μg/ml of F. hepatica extract for 24h. The cells were count every 2 days and were re-plated at the same initial density for 8 days. The release of interleukin-6 (IL-6) was evaluated by the ELISA assay. For this assay, FLS were exposed to 100μg/ml of extract of F. hepatica for 24h and then were stimulated with tumor necrosis factor (TNF-α). Extract of F. hepatica was able to decrease cell viability in 48h with the concentration of 100μg/ml when compared to DMEM group (p <0.05). In 72h, doses of 60μg/ml (p <0.001), 80μg/ml (p <0.001) and 100μg/ml (p <0.0001) of F. hepatica extract decreased cell viability when compared to DMEM group. Treatment with 100μg/ml of F. hepatica extract for 24h showed a tendency to increase IL-6 release by FLS when compared to stimulated DMEM. However, the extract did not alter adhesion capacity and long-term growth of FLS. In conclusion, extract of F. hepatica had no effect on adherence and growth over time of FLS, but showed an effect on the viability of FLS and was able to increase the release of IL-6 by FLS. Therefore, although these results are preliminary, they are important for understanding the action of F. hepatica extract on FLS and indicate an immunomodulatory effect of the extract on FLS

Benchmarking Quality in Online Teaching and Learning: A Rubric for Course Construction and Evaluation

Online courses have many components and dimensions. Both the form (structure) and the content (expression) are situated in an overall environment. The sum of these elements results in student outcomes and learning. In order to facilitate construction and evaluate the quality of an online course, a four-part rubric was designed to reflect: Structure (Context, Organization, and Environment) Content (Presentation of Information) Processes (Relationships and Interactions) Outcomes (Mastery of Content and Course Evaluation) This rubric was designed to provide quantitative and qualitative standardized evaluation for faculty self-evaluation, peer evaluation, and administrator evaluation. The rubric was piloted at two universities and shown to be highly effective in eliciting effective and usable feedback for course instructors and program directors. It was concluded that a uniform rubric that can be applied to any discipline could facilitate evaluation of all online courses within a program to a set standard that can then be used for course enhancement and improvement with structured comprehensive evaluation from instructors, peers, or program directors. It was found that a well-designed course (structure), with relevant and credible information (content), as well as mechanisms for interaction and collaboration (processes), could result in enhanced student learning (outcomes)

Síndrome da fragilidade na insuficiência cardíaca : análise de biomarcadores inflamatórios e humorais

Introdução: A fragilidade pode estar relacionada à progressão, manifestações e prognóstico da insuficiência cardíaca (IC), e embora ambas venham sendo associadas à desregulação neuro-hormonal, inflamação, catabolismo e disfunções músculo esqueléticas, ainda não há biomarcadores definidos para se avaliar fragilidade, especialmente sob perspectiva de populações com doenças cardiovasculares. Objetivo: avaliar a fragilidade através de abordagem física e multidimensional em pacientes com IC e analisar sua associação com biomarcadores inflamatórios e humorais. Métodos: Trata-se de um estudo transversal, com pacientes ambulatoriais com diagnóstico de IC e idade ≥60 anos. Variáveis sociodemográficas e clínicas foram coletadas de prontuário eletrônico. O teste de caminhada de seis minutos foi realizado para avaliação da capacidade funcional. Para avaliação de fragilidade, utilizou-se o fenótipo da fragilidade (abordagem física) e o indicador de fragilidade de Tilburg (TFI- abordagem multidimensional). As amostras de sangue foram analisadas para quantificação dos biomarcadores (proteína C reativa ultrassensível (PCR-US), interleucina-6 (IL-6), fator de necrose tumoral-α (TNF-α), fator de crescimento semelhante à insulina-1 (IGF-1) e testosterona total) a partir de protocolos padrão do hospital e kits de imunoensaio de alta sensibilidade conforme instruções do fabricante. Resultados: Foram avaliados 106 indivíduos com IC, com idade mediana de 68 (63,0-74,0) anos, a maioria do sexo masculino (67,0%), pertencentes à classe funcional I e II (75,5%) e com média de fração de ejeção do ventrículo esquerdo de 34,56±11,87%. A prevalência de fragilidade quando avaliada pelo fenótipo foi de 28,30% e pelo TFI, de 47,05%. Em análise univariada, a PCR-US foi associada à fragilidade tanto na avaliação pelo fenótipo, quanto pelo TFI (RP=1,005, Intervalo de confiança de 95% (IC95%) 1,001-1,009, p=0,027 e RP=1,015, IC95% 1,006-1,024, p=0,001, respectivamente), tendo esta permanecido significativa no modelo multivariado final na avaliação da fragilidade pelo fenótipo (RP=1,004, IC95% 1,001-1,008, p = 0,025). Não houve diferença estatisticamente significativa entre os grupos para os demais biomarcadores analisados. Também, a fragilidade foi associada a pior capacidade funcional, tratamento farmacológico não otimizado maior número de medicamentos em uso, idade, sexo feminino, e maior número de comorbidades presentes. Conclusão: A fragilidade é altamente prevalente em pacientes com IC e está associada a níveis mais altos de PCR-US, podendo ser considerada um biomarcador promissor de fragilidade nesta população e sugerindo a inflamação como uma importante rota fisiopatológica da relação IC/fragilidade.Introduction: Frailty may be related to the progression, manifestations and prognosis of heart failure (HF), and although both have been associated with neurohormonal dysregulation, inflammation, catabolism and skeletal muscle disorders, there are still no defined biomarkers to assess frailty, especially from the perspective of populations with cardiovascular diseases. Objective: to assess frailty through a physical and multidimensional approach in patients with HF and to analyze its association with inflammatory and humoral biomarkers. Methods: This is a cross-sectional study, with outpatients with a diagnosis of HF and age ≥60 years. Sociodemographic and clinical variables were collected from electronic medical records. The six-minute walk test was performed to assess functional capacity. For frailty assessment, we used the frailty phenotype (physical approach) and the Tilburg frailty indicator (TFI- multidimensional approach). Blood samples were analyzed to quantify biomarkers (high sensitivity C-reactive protein (hs-CRP), interleukin-6 (IL-6), tumor necrosis factor-α (TNF-α), insulin-like growth factor-1 (IGF-1) and total testosterone) using hospital’s standard protocols and high sensitivity immunoassay kits according to the manufacturer's instructions. Results: 106 individuals with HF were evaluated, with a median age of 68 (63.0-74.0) years, mostly male (67.0%), belonging to functional class I and II (75.5%) and with an average left ventricular ejection fraction of 34.56±11.87%. The prevalence of frailty when assessed by the phenotype was 28.30% and by the TFI, 47.05%. In univariate analysis, hs-CRP was associated with frailty in both phenotype and TFI assessment (PR=1.005, 95% confidence interval (95% CI) 1.001-1.009, p = 0.027 and PR=1.015, 95% CI 1.006-1.024, p=0.001, respectively), which remained significant in the final multivariate model in the assessment of frailty by the phenotype (PR=1.004, 95% CI 1.001-1.008, p = 0.025). There was no statistically significant difference between groups for the other biomarkers analyzed. Also, frailty was associated with worse functional capacity, non-optimized pharmacological treatment, greater number of drugs in use, age, female gender, and greater number of comorbidities present. Conclusion: Frailty is highly prevalent in patients with HF and is associated with higher levels of hs-CRP, which can be considered a promising biomarker of frailty in this population and suggesting inflammation as an important pathophysiological route of the HF/frailty relationship